Fastest growing therapeutic classes (by sales)

Oncologics, lipid regulators, respiratory agents, antidiabetics and anti-ulcerants are the five largest drug classes by sales. But annual sales are only half the story. Which drug classes are booming, and which have plateaued--or even dropped? IMS Health has released top-line industry data revealing the 15 largest drug classes, and we've crunched the numbers to take a closer look at the average sales growth of the 15 largest therapeutic classes over the last five years.


Fastest average growth:
Autoimmune agents
Lowest average growth: Erythropoietins
Biggest single-year gain: Narcotic analgesics (2006 to 2007)
Biggest single-year loss: Anti-epileptics (2008 to 2009)
Largest overall class: Oncologics

Market

2009

2008

2007

2006

2005

Avg. Growth

Autoimmune agents

18.0

19.3

17.4

21.6

32.0

17.86

Oncologics

8.8

13.4

15.8

21.6

19.2

15.76

Angiotensin II Antagonists

11.5

13.3

14.0

15.2

18.3

12.06

Respiratory Agents

11.0

5.9

11.9

11.4

13.8

10.8

HIV Antivirals

14.9

12.7

12.8

10.9

11.4

10.34

Antidiabetics

13.4

10.1

10.8

12.7

12.6

9.7

Antipsychotics

4.6

7.7

11.4

11.7

11.0

9.28

Platelet Aggr. Inhibitors

9.0

10.4

8.7

8.1

10.1

9.26

Narcotic analgesics

8.6

8.9

12.9

-1.1

3.1

6.48

Non-narcotic analgesics

7.3

4.1

7.9

3.1

6.7

5.82

Anti-epileptics

-19.8

9.8

13.7

11.3

1.3

3.26

Lipid Regulators

4.9

-1.2

-5.8

7.9

6.9

2.54

Anti-ulcerants

0.6

0.0

2.6

3.0

4.2

2.08

Antidepressants

-1.3

1.1

-6.2

3.6

-3.6

-1.28

Erythropoietins

-4.1

-13.2

-8.3

12.0

7.2

-3.48


Though oncologics are the biggest overall market, with $52.37 billion in 2009 sales, they are the second-fastest growing therapeutic class. Autoimmune agents have been growing at a faster overall pace for five years straight, averaging almost 18 percent annual growth. This category includes blockbuster biologics--like Remicade, Enbrel and Humira--that treat a wide variety of immunological diseases. Oncologics have been holding steady at 16 percent annual growth, while Angiotensin II Antagonists (which treat blood pressure, congestive heart failure and diabetic neuropathy) have see 12 percent growth. Respiratory drugs and HIV treatments round out the double-digit growth categories.


On the opposite end of the spectrum are the classes whose market is shrinking. Erythropoietins (such as Aranesp, Epogen and Procrit) experienced strong growth until 2007. Sales of the drugs dropped 20 percent in a single year following safety warnings that the class caused heart and vascular problems at higher doses. Antidepressants have also experienced a pull-back. Regulators have upgraded warnings on all antidepressants to include an increased risk of suicidal thoughts and behavior among young adults taking the meds.


A more recent trend is the almost-30 percent drop in anti-epileptic sales from 2008 to 2009. The drug class was growing at a good clip until 2008, when the FDA issued a black box warning for suicidal thoughts and behavior among patients using the meds. Physicians prescribe the drugs to treat migraines, certain types of pain and some psychiatric disorders, in addition to epilepsy. With only one year of data following the 2008 warnings, it's too soon to tell what the long-term effects on the therapeutic class growth will be.


Click here to see the top 15 drug classes by 2009 sales.